Individual
MARY HALBERT JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGPCNP
Contact information
Practice address
6300 BEACH BLVD, JACKSONVILLE, FL 32216-2708
(904) 724-9202
Mailing address
11732 HABROSO LN, JACKSONVILLE, FL 32258-2104
(904) 314-1992
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
11021289
FL
Other
Enumeration date
12/01/2022
Last updated
12/01/2022
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